目的探讨应用Ilizarov外固定装置进行关节牵张成彤治疗踝关节创伤性骨关节炎的町行性。方法回顾性分析2012年3月至2014年5月15例中度踝关节创伤性骨关节炎患者的资料，其中男10例，女5例；平均年龄为（35．6±6．5）岁。所有患者接...目的探讨应用Ilizarov外固定装置进行关节牵张成彤治疗踝关节创伤性骨关节炎的町行性。方法回顾性分析2012年3月至2014年5月15例中度踝关节创伤性骨关节炎患者的资料，其中男10例，女5例；平均年龄为（35．6±6．5）岁。所有患者接受足踝骨性畸形及软组织挛缩矫正的同时，联合应用Ilizarov外固定装置进行踝关节牵张成形治疗踝关节创份降骨关节炎。入选病例均为创伤后单侧受累，其中踝关节骨折病史者9例，踝关节扭伤病史者6例。关节牵张术后维持3个月，术后允许全负重行走。结果15例患者踝关节关节活动度（rangeofmotion，ROM）及踝关节间隙（joint space width，JSW）均得到保留。无一例施行二期关节融合或者踝天节置换术。踝关节骨关节炎评分（ankle osteoarthritis scale，AOS）术前（33．8±7．95）分，术后1年提高为（55．4±5．46）分，术后2年提高为（71.4±10．19）分，简明健康测量表（medicaloutcomes study 36-item short—form health survey，SF-36）术前（37．2±4．32）分，术后1年及2年随访时分别提高至（52．8±3．42）分和（59．2±2．95）分，各时间点的差异均有统计学意义。ROM结果显示踝关节功能改善程度在术后1年与末次随访的结果相似。患者均表现为疼痛缓解满意。放射学评估显示11例（73．3％，11／15）术前JSW为（1．42±0．29）lnnl，术后1年改善为（2．2±0．57）mm，并于术后2年维持良好，4例（26．7％，4／15）患者关节间隙术后1年及2年中改善并不显著，但AOS及SF-36评分显示临床症状改善。结论联合Ilizarov外固定装置进行关节牵张成形术治疗踝关节创伤性骨关节炎能够延缓需要进行关节融合或关节置换的时间，早期临床效果满意。展开更多
目的探讨足跟部骨定量超声(quantitative ultrasound,QUS)检查骨密度(bone mineral density,BMD)在诊断足部废用性骨质疏松症中的临床应用价值。方法本研究对2016年6~12月于我院足踝外科门诊就诊的单足损伤后限制活动超过3个月以上的80...目的探讨足跟部骨定量超声(quantitative ultrasound,QUS)检查骨密度(bone mineral density,BMD)在诊断足部废用性骨质疏松症中的临床应用价值。方法本研究对2016年6~12月于我院足踝外科门诊就诊的单足损伤后限制活动超过3个月以上的80例病人进行双足跟骨QUS检查和患足X线检查。其中男27例、女53例,年龄为18~59岁、平均(45.72±12.46)岁,右足损伤58例、左足损伤22例,平均制动或限制活动时间为(4.12±0.83)个月。BMD结果分别按照T值法和骨量丢失法进行分析,参照X线诊断标准对跟骨QUS诊断足部废用性骨质疏松症的敏感性进行评价。结果将80例病人两侧跟骨BMD数值依据骨量丢失百分率法计算:诊断为骨质疏松者24例、骨量减少者10例,漏诊18例,无误诊,敏感度为57.1%。与T值法敏感性分析(14.3%)比较明显提高,差异具有统计学意义(u=6.9325,P<0.05)。结论骨量丢失法优于T值法,但QUS诊断足部废用性骨质疏松症的敏感性低于X线法,仅能作为足部废用性骨质疏松症的初筛方法。展开更多
[Objective]This study was designed to describe the fracture patterns and early results of operations of posterior Pilon fractures through a posterolateral approach.[Method]This study consisted of 14 cases,10 males and...[Objective]This study was designed to describe the fracture patterns and early results of operations of posterior Pilon fractures through a posterolateral approach.[Method]This study consisted of 14 cases,10 males and 4 females with the mean age of 47 years(range,28-63 years).The causes were traffic accident in 2,falling in 6 and sprain injuries in 6 cases.The duration from injury to operation was 7-14 days.Including 12 cases combined with distal fibula fracture and3 cases with medial malleolus fracture.There were 3 posterior dislocation fracture.All cases were treated with open reduction and internal fixation(ORIF).[Result]A consistent fracture pattern was identified with a primary,inferiorly posterior Pilon fracture that likely occur through a combined rotational and axial load mechanism.The average duration of follow-up was 26(range,24-37)months.The postoperation average of American Orthopedic Foot Ankle Society score(AOFAS)was 92points which was much higher than before operation.Anatomical reduction were obtained in all cases.Two complications(1wound superficial infection and 1 sural cutaneous nerve injury)were all managed nonoperatively.[Conclusion]Posterior Pilon fractures form a consistent pattern.They can be successfully managed through a posterolateral approach with direct reduction and buttress fixation of articular fragments.展开更多
文摘目的探讨应用Ilizarov外固定装置进行关节牵张成彤治疗踝关节创伤性骨关节炎的町行性。方法回顾性分析2012年3月至2014年5月15例中度踝关节创伤性骨关节炎患者的资料，其中男10例，女5例；平均年龄为（35．6±6．5）岁。所有患者接受足踝骨性畸形及软组织挛缩矫正的同时，联合应用Ilizarov外固定装置进行踝关节牵张成形治疗踝关节创份降骨关节炎。入选病例均为创伤后单侧受累，其中踝关节骨折病史者9例，踝关节扭伤病史者6例。关节牵张术后维持3个月，术后允许全负重行走。结果15例患者踝关节关节活动度（rangeofmotion，ROM）及踝关节间隙（joint space width，JSW）均得到保留。无一例施行二期关节融合或者踝天节置换术。踝关节骨关节炎评分（ankle osteoarthritis scale，AOS）术前（33．8±7．95）分，术后1年提高为（55．4±5．46）分，术后2年提高为（71.4±10．19）分，简明健康测量表（medicaloutcomes study 36-item short—form health survey，SF-36）术前（37．2±4．32）分，术后1年及2年随访时分别提高至（52．8±3．42）分和（59．2±2．95）分，各时间点的差异均有统计学意义。ROM结果显示踝关节功能改善程度在术后1年与末次随访的结果相似。患者均表现为疼痛缓解满意。放射学评估显示11例（73．3％，11／15）术前JSW为（1．42±0．29）lnnl，术后1年改善为（2．2±0．57）mm，并于术后2年维持良好，4例（26．7％，4／15）患者关节间隙术后1年及2年中改善并不显著，但AOS及SF-36评分显示临床症状改善。结论联合Ilizarov外固定装置进行关节牵张成形术治疗踝关节创伤性骨关节炎能够延缓需要进行关节融合或关节置换的时间，早期临床效果满意。
文摘目的探讨足跟部骨定量超声(quantitative ultrasound,QUS)检查骨密度(bone mineral density,BMD)在诊断足部废用性骨质疏松症中的临床应用价值。方法本研究对2016年6~12月于我院足踝外科门诊就诊的单足损伤后限制活动超过3个月以上的80例病人进行双足跟骨QUS检查和患足X线检查。其中男27例、女53例,年龄为18~59岁、平均(45.72±12.46)岁,右足损伤58例、左足损伤22例,平均制动或限制活动时间为(4.12±0.83)个月。BMD结果分别按照T值法和骨量丢失法进行分析,参照X线诊断标准对跟骨QUS诊断足部废用性骨质疏松症的敏感性进行评价。结果将80例病人两侧跟骨BMD数值依据骨量丢失百分率法计算:诊断为骨质疏松者24例、骨量减少者10例,漏诊18例,无误诊,敏感度为57.1%。与T值法敏感性分析(14.3%)比较明显提高,差异具有统计学意义(u=6.9325,P<0.05)。结论骨量丢失法优于T值法,但QUS诊断足部废用性骨质疏松症的敏感性低于X线法,仅能作为足部废用性骨质疏松症的初筛方法。
文摘[Objective]This study was designed to describe the fracture patterns and early results of operations of posterior Pilon fractures through a posterolateral approach.[Method]This study consisted of 14 cases,10 males and 4 females with the mean age of 47 years(range,28-63 years).The causes were traffic accident in 2,falling in 6 and sprain injuries in 6 cases.The duration from injury to operation was 7-14 days.Including 12 cases combined with distal fibula fracture and3 cases with medial malleolus fracture.There were 3 posterior dislocation fracture.All cases were treated with open reduction and internal fixation(ORIF).[Result]A consistent fracture pattern was identified with a primary,inferiorly posterior Pilon fracture that likely occur through a combined rotational and axial load mechanism.The average duration of follow-up was 26(range,24-37)months.The postoperation average of American Orthopedic Foot Ankle Society score(AOFAS)was 92points which was much higher than before operation.Anatomical reduction were obtained in all cases.Two complications(1wound superficial infection and 1 sural cutaneous nerve injury)were all managed nonoperatively.[Conclusion]Posterior Pilon fractures form a consistent pattern.They can be successfully managed through a posterolateral approach with direct reduction and buttress fixation of articular fragments.
